Consolidated Financial Statements Adventist Health System ...
MATTERS - Adventist Health · 2019-07-12 · Love matters, and it’s how and why we serve. We...
Transcript of MATTERS - Adventist Health · 2019-07-12 · Love matters, and it’s how and why we serve. We...
M A T T E R S
2 019 M I S S I O N R E P O R T
L O V E M AT T E R S | 3A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 2
Living God’s love
by inspiring health,
wholeness and hope.
M A T T E R S
L O V E M AT T E R S | 5A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 4
Last year was filled with great opportunity and unique new challenges for
Adventist Health. We continued our journey to transform care, business
operations and our communities. As the year progressed, we celebrated
extraordinary progress toward top-decile safety and high reliability.
We also recommitted our entire organization to love. Yes, love. With God’s
help, and through reflection of His love, we will become the agents of hope
for a hurting world. Love matters, and it’s how and why we serve.
We pulled together as ONE Adventist Health to restore healthcare services
and extend our mission to the community of Tulare, California, in record
time. This beautiful central California community is now stronger because
of our commitment to their well-being. A few months later we once again
came together in support of our associates and community as Paradise,
California, endured historic destruction from the Camp Fire. In both cases,
we showed how strong our team is when we put our trust in God and in
each other.
Looking forward we remain focused on successfully building a strong
foundation for our future. We have intentionally disrupted Adventist Health
over the past five years so we can be better positioned to deliver on our
calling to transform communities in an evolving healthcare environment.
By the end of next year, we will have nearly doubled the lives we serve.
We must leverage our successes to become significant in the industry and,
most importantly, in the lives of our community.
Adventist Health is on a bold journey to establish sustainable significance
with a vibrant mission of living God’s love by inspiring health, wholeness
and hope. With curiosity and an open mind, we will advocate for and lead
change in healthcare and social policy to benefit the under privileged
and the disenfranchised in the diverse communities to which we have
been called.
Together we will create lasting impact in people’s whole lives and affect
profound improvement in the well-being of the entire community.
Ricardo B. Graham Scott Reiner
Chairman of the Board Chief Executive Officer
The new Adventist Health headquarters in Roseville, California, opened in April 2019 and nurtures the
lives of our associates. The 275,000-square-foot building is the work home to over 1,200 associates
and is full of light and inspiration, with scripture and references to our mission built into the walls, literally.
The spaces are designed for meaningful connections, so we can serve with our best selves. Here we can
also set a vivid example of health and wholeness for our community as we welcome them to our Vitaliz
Café, onto our beautiful 1-mile walking path, and into a better understanding of who we are as a
leader in faith-based healthcare.
We incorporated two internationally recognized sets of standards into the design and construction of
the campus. The LEED green building program focuses on buildings that are designed, constructed and
operated for improved environmental performance which is vital to community health and sustainability.
WELL standards are designed around the people who live, work and make use of the space, including
how it is used, maintained and how people function within it. The building promotes both environmental
sustainability and human health and well-being, another expression of the Adventist Health mission.
Dear friends and colleagues:
ABOVE: Scott Reiner, CEO and Ricardo Graham, chairman of the board, stand with our inspirational sculpture at the entrance of the new system headquarters in Roseville, California. RIGHT PAGE: Scott and Ricardo tour the Vitaliz Café, meeting Chef Nina Curtis, and sit down with associates in one of our collaborative, open work spaces.
L O V E M AT T E R S | 7
E V E R Y
C O U N T S
A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 6
L O V E M AT T E R S | 9A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 8
Faith forged from fire
“This has the potential for a major incident.”
—Firefighter to dispatch
Fire starts in Pulga mountains east
of Paradise.
Code Triage External called.
EVACUATION ORDER: Due to a fire in the area, an evacuation order has been issued for all of Pentz Road in
Paradise east to Highway 70. Leadership meeting called for 8:00a.m.
Code Black called — Full evacuation of hospital campus.
On November 8, 2018, the Camp Fire roared through the Feather River Canyon and into the town of
Paradise, California, leaving devastation and destruction in its wake. Adventist Health Feather River
miraculously evacuated all 67 patients safely, many in the personal vehicles of associates who
drove through the wind-whipped fire. It was dangerous and frightening for everyone and
also a defining moment for Adventist Health associates. With courage, determination and
grace, our mission was demonstrated in a profound and powerful way.
Critical parts of the hospital burned and more than 600 associates
lost their homes, cars and possessions. Adventist Health has reopened
clinics and relocated associates to other markets, while focusing
their work on helping the community recover.
Flames became visible across the hospital campus. “This fire
is moving football-field lengths within seconds.”
—Cal Fire spokesman Scott McClean
Patient evacuations begin.
Ryan Ashock was the administrator on duty that
day. “When our team received information that
our campus was surrounded by flames and that
no fire personnel was available, we made the
quick decision that evacuating the Pentz Road
campus was a necessity. Within 35 minutes, 67
inpatients, hundreds of employees, physicians
and volunteers were safely evacuated out of
the hospital. This incredible feat of evacuating
in such a short period of time was only possible
due to the outstanding teamwork by everyone
involved. Each and every one of the associates
involved that day is a hero.
That day and throughout the recovery, the
Feather River team lived the mission of Adventist
Health like no one has before. In the scariest
of times, we lived God’s love by inspiring each
other, our community and our patients with
health, wholeness and, most importantly, hope!”
Nurse Tamara Ferguson was working with
other medical staff to evacuate patients in
two ambulances with little time to spare. The
ambulances were on a narrow road heading
away from the fire, seeking a safe route out of
town. They were about a mile from the hospital
when the ambulance in front of Ferguson broke
down and started to melt.
“We were behind them. There was nowhere
we could go,” Tamara says. “We turned at the
closest cul-de-sac, and we found the one house
that was not on fire. We had to break into it.”
The paramedic crawled into the doggy door then
opened the garage door from the inside. They
quickly unloaded the three patients and settled
them in the garage.
Ferguson says she was sure she was going to
die. “I made phone calls to my family and said
goodbye.”
But Paradise Fire Chief David Hawks found them
and swiftly gave everyone orders, likely saving
their lives. Some people climbed on the roof with
hoses, others cleared pine needles from gutters.
(continued on next page)
Confirmation received that 50 people (including people from the
surrounding community) were trapped on the helipad.
Patients transported in ambulances and private cars. Staff realize that
ambulances cannot get through and begin loading patients into their own cars,
making patients as comfortable as possible. Two ambulances arrive …
neither of them make it out of town.
Leaders continue checking to confirm who was working and their whereabouts.
The staff stays at receiving hospitals to monitor patients.
Evacuation completed: 67 inpatients, 120 outpatients, 500 staff.
The command center received the first report that some staff and
patients had been turned around and were now trapped at the hospital.
Notified that staff who were trapped were safely evacuated
and taken to Enloe Medical Center for evaluation.
The Camp Fire burned through the town of Paradise, obliterating
thousands of homes. Within 24 hours of starting, the Camp Fire is the most destructive fire in California history.
6:33a.m. 6:43a.m. 7:41a.m. 7:56a.m. 8:00a.m. 8:05a.m. 8:09a.m. 8:18a.m. 8:25a.m. 8:43a.m. 11:00a.m. 12:00p.m. 12:30p.m. 1:45p.m. 8:00p.m.
courage
A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 10 L O V E M AT T E R S | 11
Immediately after the firestorm, the
Roseville office of Adventist Health launched an emergency call center to
provide immediate assistance to our
Feather River clinic and hospital patients
and community members. Over the next
several weeks the call center logged
about 1,000 calls a day. Some calls were
simple prescription refills, and some were
heartbreaking stories of fear, loss and
grief. The Roseville team was joined
by Adventist Health Feather River,
Adventist Health Lodi Memorial and
Adventist Health Sonora associates along
with members of clinical informatics,
ITWorks (Cerner), pharmacy and others.
The experience impacted every person
involved.
“There was fire all around us, the house next
door to us was on fire. He told us what to do.
We all worked together,” says Hawks.
The group of 13 people, including three
patients (one who had just delivered a baby by
C-section), nurses and a pediatrician, hunkered
down in the garage for two hours, waiting for
the fast-moving flames to pass. Medical staff
and firefighters continued to clear brush and try
to keep the house safe. Finally, a sheriff’s van
pulled up and the whole group piled in, heading
to a different hospital several miles away.
Everyone was safe.
The next day Tamara reflected, “I will forever
be changed by yesterday as so many thousands
of others are, but not by what was physically
lost, but the reminder that life changes quickly.”
Anthony Villasana, CT technologist, describes
his experience: “You would of been so proud
of all of our people evacuating, and lifting
patients as quickly but ever so gently, as this
urgent and furious time would allow. The wind
was blowing embers and small branches. I
went to my truck and grabbed my running
shoes and a beanie to protect my face. I
placed the beanie over my nose and mouth
and began to run. As I ran I could see others
trying to make the decision to abandon their
cars. I continued until a car slowed down and
the lady driving said to me, ‘Hey, I know you.
You work at the hospital, right? You took care
of my mother, and she loved you. Get in, and
I’ll take you down to Chico.’ I asked her what
her name was, and she said, ‘It’s Hope.’ ”
Tamara Ferguson, front, takes a selfie in front of a Paradise, California, house with a group trapped by flames: nurse Chardonnay Telly, (left), firefighters Matt Arness and Joe Greco, EMT Shannon Molarius and Dr. David Russell, (back).
Camp Fire Call Center
“Working a call center was not easy, and it was
emotionally taxing to hear some of the horror stories.
I will never forget one woman crying to me as she
recounted jumping in a nearby lake to save herself
as the fire burned. But each patient, most of whom
had just lost everything, simply felt grateful to be
alive and gave thanks to God for that second chance
and thanks to us for listening and helping with their
medical and prescription needs. They took the time
to ask me how I was and how their providers were.
That level of human concern for a stranger after
losing everything was truly remarkable. It reminded
me that I am exactly where I want to be in life and
that my personal values align with the work I do.”
— Tiffanie Porter, senior training program
analyst, Adventist Health Physician Services
“We spent hours making phone calls to patients
asking if they were safe and how we could help
them. Adventist Health made a commitment to reach
all patients who had appointments scheduled and
make sure that, though those appointments were
canceled, we would do whatever we could to help
them get their needs met. We’ve had employees
from all over the organization and even from other
hospitals come to help make those calls.”
— Jill Parish, lead training program associate
“The greatest impact for me was the group of staff
from Adventist Health Feather River that got on a
shuttle and came to Roseville day after day, working
10 hours plus the over two-hour drive each way.
Many lost their homes, knew people who did not
make it out and didn’t know if they still had a place
to work. They never complained or felt sorry for
themselves, but instead showed compassion, love
and grace for our patients. We shared many tears
of joy and sadness as news would come in. They
remained strong and dedicated to the purpose.”
— Bekah Richey, senior training program analyst,
Adventist Health Physician Services
“Answering dozens of calls each day was a life-
changing experience for me. For many, everything
they knew and had was gone, and for them to hear
an actual person on the other line meant the world
to them. To have someone to talk to provides a
glimmer of hope. To know that Adventist Health
was there for them, even in this disaster, was what
people needed. I remember asking everyone, ‘Are
you in a safe location and is there anything I can
do for you?’ People were not expecting a phone call
from us, especially to see if they were OK. For me,
their heartfelt stories of survival were what kept my
focus on what was important — not the number of
calls, or the hours we put in — it was about being
there for people who had nothing. I truly felt that
I was living our mission during my six weeks of
working the Camp Fire call center. My perspective
of living our mission has changed since then as
well. It has opened my eyes to know that even at
a desk in Roseville I can make a difference in our
patients’ lives.”
— Stacey Mathison, data support analyst,
Adventist Health Physician Services
A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 12
Sur viving and Thriving
L O V E M AT T E R S | 13
To see Jennifer Hennick today — young,
vibrant, enjoying a milestone in her nursing
career at Adventist Health Bakersfield and bringing together other young women
for a “glam photo shoot” — you would
never imagine the road she has traveled.
At 28, she was a single mom of two
children, doing her best to raise them and
get herself through nursing school. She
dreamed of graduating, finding a position
as a registered nurse and planning her
family’s future.
Then, she discovered a lump in her breast, which
would eventually lead to those three words that
would change her life’s path: You have cancer.
“My immediate gut feeling was terrible, and the
alarms were sounding,” recalls Jennifer about
first finding the lump. “But instead, I began to
frantically search for another explanation.” At
the time, she hoped it might be a seat belt injury
resulting from a car accident a few months
earlier.
She knew she had to be checked by a
professional. However, this created yet another
stressful crisis because she was uninsured. Like
so many others, Jennifer was just trying to get by
financially day-to-day and never imagined she
would need health insurance.
Fortunately, Jennifer benefited from the Links
for Life program that paid for her imaging and
biopsy appointments, which confirmed she did,
in fact, have breast cancer. She qualified for
Medi-Cal coverage and underwent surgery for
a left modified radical mastectomy in October
2005, followed by chemotherapy that lasted until
January 2006.
Today, Jennifer remains cancer-free. Her dreams
of working in oncology were realized when
she was hired as the nurse practitioner for the
Adventist Health Breast Center in Bakersfield.
The perspective she brings as a breast cancer
survivor — at such a young age, no less — is
invaluable to prospective patients.
In fact, it’s because of Jennifer, that a Young
Survival Coalition (YSC) chapter has returned
to Bakersfield. During her breast cancer battle,
she found great solace, comfort and kinship
in this group of young women facing so many
similar situations. However, over time, the
local organization had dissolved — which was
something she wanted to change.
“As soon as I started at the Adventist Health
Breast Center, I knew that I needed to bring
YSC back,” Jennifer says. “YSC’s mission is all
about sisterhood, support and resources. We
work with survivors, caregivers and the medical
research, advocacy and legislation communities
to increase quality and quantity of life for young
women with breast cancer.
“We are here to educate, empower and connect
our local young ladies who have been diagnosed
with breast cancer. We want them to know we
are in this together.”
The gatherings offer the women opportunities for
support, while also providing something fun to do
as a group. After all, sometimes girls just want to
have fun!
To inspire other young women going through
breast cancer, Jennifer and her united sisters,
some still at the beginning or the middle of their
breast cancer journeys, gathered in downtown
Bakersfield for a special “glam photo” session.
Their gowns, donated by generous community
members, empowered these ladies to show that
cancer can’t steal their sense of style.
“Our portraits show beauty, grit and sisterhood … the very definition of the Young Survival Coalition Bakersfield,” Jennifer says.empowerment
L O V E M AT T E R S | 15A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 14
It’s a Friday morning at Blosser Lane
Elementary School in Willits, California,
and more than 100 students are running
and walking laps around the basketball
court, laughing and having fun. They’re
part of a new before-school program
called “Morning Mile” sponsored by
Adventist Health Howard Memorial. “Anything to help us get students moving is a
good thing. It really warms my heart to see so
many kids, staff and community members
participating. The other day I saw kids rushing
as the bus pulled up, and they were so excited
to get their laps in. Besides the health benefits,
it also allows the kids to release all that energy
and get them ready to learn. It’s a win for both
teachers and students,” says Nancy Runberg,
Blosser Lane principal.
The program was initiated by teacher Tiffany
Klee, along with Tina Tyler-O’Shea, senior
program specialist with the Mendocino County
Health and Human Services Agency.
Adventist Health Howard Memorial donated
funds to get the program started. Jason Wells,
president, says, “Childhood obesity is a growing
problem, and anything we can do to help address
it is a step in the right direction. And this ties
perfectly with our mission of inspiring health in
our communities. While we love taking care of
kids when they’re sick, we would rather keep
them healthy and well. Starting healthy habits
while they’re young can set them up for a
great future and better health outcomes for the
community as a whole. We hope more schools
get on board, and we will be happy to support
them in any way we can.”
It’s not just students who participate in the
program. Parents and teachers are having fun
and walking too. Six laps around the loop is
exactly a mile, and students aim to get more than
that. Each lap earns the prize of a straw, to be
recorded and tracked for more incentives. Every
participant receives a necklace and a charm for
every 5 miles.
Kaiden Oliver is a fifth grader who says he loves
running, as he shows off the charms he’s earned
around his neck. “I did 15 laps today! Tomorrow,
I’ll be even better!”
After he’s done, he encourages his friends to keep
going, giving them high-fives along the way.
Morning Mile for a healthy start
Kaiden’s mother, Amy Buckingham, says the
program has been a blessing for Kaiden. “He
has a lot of energy. Now he has an outlet for all
that energy, and he’s ready to learn and to pay
attention to his studies. As a mom and a nurse,
this program excites me. Running and exercise
has been proven to offer many health benefits,
including strengthening your lungs, relieving
stress, improving your immune system and
preventing high blood pressure.”
Before school starts, the kids hand in their straws
to be tallied. By the end of the school year, nearly
200 students have put in their miles. Students,
staff and guests have walked almost 1,700 miles.
Adventist Health Sonora’s Project
Impact inspires health throughout the
community with volunteer opportunities
extending beyond traditional healthcare.
One of Project Impact’s most creative and
meaningful community outreach activities
occurred in September 2018, when 40 hospital
associates, administrators and physicians visited
Gold Rush Mobile Home Park in the nearby town
of Columbia, California. They fixed and painted
decks and stairs, repaired screens, trimmed trees,
power-washed roofs, removed trash and delivered
sack lunches, toilet paper, paper towels, and
heaters for those with no heating source in their
home. Nurses and techs, assisted by the chief
medical officer, provided free health screenings
and foot care, something many residents had not
received in years. Those requiring follow-up care
were given clinic appointments.
The visit had another important impact —
helping to reconnect the mobile home park
residents to each other and the community.
“They’ve faced so much difficulty that they were
suspicious of people trying to give them help with
no strings attached,” explains Julie Kline, patient
care executive. “So the team went door to door
offering assistance. Residents were both amazed
and appreciative.“
“I had lost faith in the medical community,” says
one mobile home owner. “Coming to this event
I feel like I am not just another number. This has
restored my faith in the medical field.”
“One resident told me that in the past, people
had always shunned him because of his
appearance,” says chaplain Mario DeLise.
“Knowing there are people who care about
him meant more than all the things we fixed at
his home.”
Impact and inspiration“They were shocked that the hospital took the
time to come out and help this little community,”
says Valerie Shumake, administrative director
of operations. “The daughter of one resident
expressed her gratitude that her mom was no
longer in danger of falling through her rotting
porch deck.”
Mario says the mobile home park visit
exemplified what Project Impact is all about:
making the community a better place because
Adventist Health is there.
“This is the most grassroots, meaningful and
purposeful work you’re going to find,” says Julie.
“It’s a powerful purpose that renews your faith
and fills you with gratitude.”
energy
purpose
L O V E M AT T E R S | 17A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 16
Just moments after waking up and
stepping onto her patio for a cigarette
and a cup of coffee, Michelle Weller was
brought to her knees. The pain was
unbearable as a ripping sensation tore
through her chest. She dropped her
cigarette, stumbled inside and hollered
for someone to call 911.
“I want to die,” Weller says. “That’s what I was
thinking. The pain was that bad. I thought I was
going to die.”
But nurses at Adventist Health Tehachapi Valley wouldn’t let her.
Weller’s nurses, Rebecca Mateiro and Michelle
Adams, diagnosed an aortic dissection, a serious
condition occurring when the inner layer of the
aortic blood vessel branching off the heart tears.
It’s often fatal.
The dissection was caused by a combination of
smoking, stress and heredity. Michelle had been
a smoker for 35 years, ignoring family members
when they asked her to quit. She would stress
easily over little things. Her father had died of an
aortic aneurysm and her brother died of an aortic
dissection. She was terrified.
At a critical access hospital in a rural community,
options for treatment are limited. The nurses
called hospitals nearby to see if a cardiothoracic
surgeon was available to perform immediate
open-heart surgery. They found just one —
at Loma Linda University Medical Center.
Meanwhile, Michelle’s pulse dropped to 20 beats
per minute. Her kidneys began shutting down.
She faded in and out of consciousness, and a
chaplain stood bedside. When her daughter
Heather Silva arrived, Mateiro cried with her, and
then prayed for her mother.
“I told her we would do what we could to give
her a fighting chance,” Mateiro recalls. “She was
going to make it — just as long as we got her the
surgery she needed.”
Because of the smoke caused by wildfires blazing
across Southern California, flying a helicopter
into Loma Linda would be impossible.
“We can’t wait,” Mateiro told them. Within
30 minutes they had arranged an ambulance,
inserted a breathing tube in Michelle’s throat and
packed everything they needed to keep their
patient alive.
Adams and Mateiro traveled alongside the
ambulance for the two-hour drive into Loma
Linda, and provided her daughter, Heather, with
text updates.
“I remember them wheeling her out, and the
nurses were right there with her. You wouldn’t
expect going to work and then end up driving
almost three hours with a patient. They didn’t
even hesitate. I’m so thankful. They didn’t even
think twice,” Heather says. “They were going to
do whatever they had to do, and I felt she was
in really good hands. If it weren’t for Michelle
(Adams) and Rebecca (Mateiro), my mother
would not be here. They saved her life.”
Michelle’s operation was successful, and the
experience set her on a healthier path. She no
longer smokes. She finds ways to reduce stress
in her life, and she’s begun watching her diet and
limiting her portions. She’s finding ways to be
heart healthy so that she can be there for her five
grandkids (and a new one on the way).
“All these years my family told me to quit
smoking and that it would kill me. I came so
close,” Michelle says through tears. “I don’t want
the people I care about to ever feel what I felt.”
Now, 50 years later, Adventist Health has picked
up where the Schlotthauers left off. In November
2018, Adventist Health Tehachapi Valley
opened a new, state-of-the-art hospital, ushering
the region into a new era of healthcare while
paying homage to the area’s roots. For many, the
opening of the new hospital was a community
celebration. During a time when hospitals in rural
communities across the nation are shuttering,
Tehachapi had achieved what seemed impossible.
Healthcare in Tehachapi, California, has always been a product of community investment.
When Harold and Madge Schlotthauer, a husband-and-wife team of Seventh-day
Adventist doctors trained at Loma Linda University Medical Center, came to Tehachapi in
1934, it was to provide healthcare to the underserved. They purchased and converted
a two-story hotel to establish the first hospital the rural community had ever known.
They built clinics across the region, stressing preventive care and offering free well-baby
clinics. They partnered with schools to offer vaccinations and provide nutritional
information to parents. The couple practiced medicine until they sold their hospital and
retired in 1969.
For too long, residents in Tehachapi and east
Kern County were forced to travel up to 90
minutes for care because their hospital lacked
services. Some would forgo care altogether. But
since opening, emergency department volumes
have spiked, suggesting that those residents who
used to travel are now staying local for care. The
intensive care unit team has nursed critically ill
patients back to good health, and they did it close
to home where it is convenient for their families
to visit.
A heritage of community investment
Most importantly, the hospital’s team of
compassionate caregivers provides the
highest quality of care because they love
their community and know their friends and
neighbors deserve nothing less.
Drs. Harold and Madge Schlotthauer would
be proud.
Tehachapi’s first hospital in 1934 was operated out of a hotel, shown above. Almost 50 years later, community members celebrated the opening of Adventist Health Tehachapi Valley in a state-of-the-art facility.
A fighting chance
commitment
L O V E M AT T E R S | 19A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 18
It was the end of 110 days of furious
activity that began when Tulare Local
Healthcare District, in Tulare, California,
agreed to partner with Adventist Health
to reopen the local hospital. It was also the
beginning of a new healthy chapter for
the community.
“Opening day was one of the most special days
I can remember. A lot of tears, a lot of joy, a lot
of happy faces in the crowd for people that really
wanted their healthcare system to come back to
Tulare. For us to be a part of that was a high point
of this journey,” recalls Randy Dodd, president
and interim executive for Adventist Health Tulare during the reopening phase.
Among the renovations were new floors,
remodeled nurses’ stations, a new nurse-call
system, a repainted lobby, entirely repainted
hospital exterior, landscaping, signage and kitchen
upgrades. There were also regulatory and
connectivity hurdles to clear, supplies to order,
public meetings to attend and presentations to
make, plus 260 new associates to onboard and
a public vote for final approval hanging in the
balance.
“Every single day we came upon a new
challenge, but almost immediately the solution
surfaced,” Randy says. “It’s amazing the amount
of work that can get done when we are focused
and everybody is committed to a timeline.
“We live our mission here in Tulare by restoring
hope to this community, and what I saw when I
first got here was frustration, anger, skepticism.
As we’ve moved through the process, I began to
see their hope restored and people believed that
maybe they’re really going to get their hospital
back.”
Wherever they went, Adventist Health
leaders encountered a warm welcome and an
overwhelming “go Adventist Health!” attitude
from Tulare residents.
“Opening this hospital gives us an opportunity
to show you how we can live God’s love, and
we will do that every single day by taking
care of your community and exceeding every
single expectation that you have,” Andrea Kofl,
president of Adventist Health services in the
Central Valley, said at the celebration. “If you
think this is something, you just wait.”
Joshua Roy, who was the first emergency patient
at the Tulare hospital, says he is beyond grateful
the hospital is open. “Your health is all you’ve
got. I’m just lucky you guys were open,” he says.
By the end of the first day, 67 patients had been
seen at the emergency department, with four
transferred for further treatment elsewhere and
nine admitted to the hospital.
“They believe in us now, they know now that
we’re for real, that we’re here to help them,”
Randy says. “I couldn’t have asked for anything
more satisfying than in seeing the people here
and being able to help serve them.”
Restoring hope and health in Tulare
For the fourth year, the Southern California Region partnered with Armenia
Fund for Compassion in Action — Mission
Armenia, a medical mission delivering
critical care, lifesaving surgeries and
medical expertise. The 2018 mission was
made possible by the generous support
of donors and Mr. Hacop Baghdassarian’s
wife, Hilda, and his family.
Men, women and children filled hallways at
Noyemberyan Hospital and Stepanakert Repub-
lican Medical Center in Armenia. Among them
was a 48-year-old man with a brain aneurysm.
Without emergency treatment, he may have died.
Alice Issai, president of Adventist Health Glendale
and one of 60 volunteers, recalls that moment.
“He thought his only option was flying to St.
Petersburg, Russia,” she says. “It felt like a miracle
when we could help him.” Mikayel Grigoryan, MD,
Armenia-born Adventist Health Glendale
interventional neurologist, worked side by side
to mentor doctors and save the patient.
Another patient was diagnosed with a severe
heart condition. His only option was open-heart
surgery in Yerevan — a five-hour drive from
Artsakh. The cost was a devastating $30,000.
Adventist Health Glendale and the Health
Ministry of Karabakh removed the burden by
covering the cost.
The team performed 270 procedures and major
surgeries, from total knee replacements and
hysterectomies to lifesaving cases in cardiology,
neurology and electrophysiology. Another 2,240
visits and consultations were given to primary
care, oncology, gynecology and pediatric
patients, in the hospitals and in surrounding
villages, where free prescriptions were also
distributed.
“Women’s health issues are heart-wrenching,”
says Ramella Markarian, Adventist Health
Glendale business development executive.
Laurence Spencer-Smith, MD, Adventist Health
White Memorial obstetrics/gynecologist,
performed numerous surgeries. “He ended
the suffering of many women with uterine and
bladder prolapses and disabling gynecologic
disorders, which are easily treated in the U.S.”
The mission concluded with treating 305 patients
in the villages of Harav, Shushi and Krasni in
Artsakh. The seamless operation included a
triage area, primary care physician consults,
education and medication for the villagers.
“We helped develop the foundation of
healthcare for future security and growth,” says
Arby Nahapetian, MD, regional medical officer,
Southern California Region. “To create
sustainability, we educated and trained local
physicians and nurses so they can provide the
same care in exponential numbers.”
Looking back on her experience in Armenia,
Yi Shen, RN, Adventist Health Glendale,
reflected, “I’ve learned to treat the emotional and
spiritual needs of a patient. Mission work changes
the lives of patients. In return, the lives of
healthcare providers are also changed forever.”
First pacemaker implant in Artsakh. From left, Carlos Biaggi, cath lab technician; Gevorg Amirjanyan, MD, Armenia-based physician; Arby Nahapetian, MD, cardiologist, Adventist Health Southern California Region medical officer.
solutions
mission
Saving lives in Armenia
L O V E M AT T E R S | 21
E V E R Y
M AT T E R S
A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 20
A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 22
Getting AHEAD of cancerThe Adventist Health Early All-Around
Detection (AHEAD) program enables
patients to identify their risk of hereditary
cancer syndrome and helps those who are
at higher risk with options to reduce their
risk or to actually prevent cancer.
Candace Westgate, DO, an obstetrician/
gynecologist based at Adventist Health St. Helena, is the medical director of the
AHEAD Program.
“My mission is to prevent cancer and
save lives,“ says Dr. Westgate. “Where
we come from does not necessarily mean
were we will end up, but it can influence
our journey. Knowing and being aware of
your family history can be the key that
unlocks your individualized risk of cancer
and possibly even uncover if an abnormal
genetic mutation is the cause. Affecting
our communities at the population health
level can make lasting changes for
generations to come. Moving away from
a one-size-fits-all approach to cancer risk
assessment and management improves
our quality of care and patient satisfaction.
This is a tangible way of living God’s love
with each patient, as He has created us all
so uniquely.”
BRENDA’S STORY
When Brenda Munson visited Dr. Westgate
for an exam, her family history revealed that
Brenda’s paternal grandmother had breast
cancer and her paternal aunt had ovarian cancer.
Dr. Westgate recommended genetic testing with
the AHEAD Program.
“It was positive for BRCA1* and I didn’t believe
it. It took me about a year to deal with it because
I was in quite a bit of denial,” says Brenda.
Brenda’s risk of having breast cancer was 87
percent and her risk of ovarian cancer was 40-60
percent. After professional counseling with Dr.
Westgate, Brenda and her husband determined
that a prophylactic double mastectomy was the
best preventive option. “These numbers were just
too high to live with. I am really lucky because
I was able to make decisions based on having
these statistics,” Brenda says.
BRENDA
Three months after Brenda’s double mastectomy,
she had a hysterectomy and oophorectomy.
“It was a tough decision, but I made it because it
was the best thing for me; it was the best thing for
my family. I can live my life and I am at peace.
And even more important is being a part of my
family’s life and to be able to watch my two
boys grow,” she says.
“I am 100 percent. I am as strong as before, if
not stronger. Short term this can be very
daunting, but in the long term I would do this
100 times over.”
TONI’S STORY
Cancer runs in Toni’s family, and she lived with
the fear of ovarian cancer for decades. “I was
very careful to monitor my ovaries; I had yearly
sonograms and CA125 tests, but I never really
worried about breast cancer,” says Toni. With
the advancement in genetic testing, Toni was
advised to test for genetic mutations and tested
positive for BRCA2. She prophylactically had her
ovaries and fallopian tubes removed.
In October of 2015, Toni saw Dr. Westgate for
a clinical exam. Dr. Westgate was concerned
that Toni had not considered a mastectomy,
as people with her mutation have risks of up to
87 percent for developing breast cancer.
“I chose to have a double mastectomy with
direct to implant reconstruction in January 2016,”
Toni explains.
“Reducing the chance of cancer anytime you can
is a smart move. I did not want my wife to have
to worry about this any longer,” Toni’s husband
says.
Smiling, Toni concurs, “It is a peace of mind that
we all deserve to have.”
MARIA’S STORY
“My advice to anyone who has a family history of
cancer is to be informed, talk to your doctor and
find out what you can do.”
Maria was diagnosed with breast cancer when
she was 35 years old. One month later, she was
told she was BRCA1-positive. Maria’s high risk
of 87 percent for developing breast cancer had
already been realized. She had to face a 40–60
percent risk of ovarian cancer during her lifetime.
Learning from Maria’s experience, her sister
had genetic testing and tested positive for
BRCA1. Considering the overwhelming odds of
contracting breast cancer and ovarian cancer,
she too opted have a double mastectomy and a
hysterectomy.
Maria has three daughters, and just recently her
oldest, 19 years old, asked to be tested. The
results were negative; she falls into the normal
population, a great relief to Maria.
“Discovering that I am BRCA1-positive has
been a great finding for me and my family. My
sister’s discovery has made it possible for her to
make lifesaving choices. For my daughters, this
information will be very helpful as well. They
now have choices, not a sentence. Knowing your
family history can save your life and the lives of
those you love most.”
TONI MARIA
* A BRCA mutation is a mutation in either of the BRCA1 and BRCA2 genes, which are tumor suppressor genes. Hundreds of different types of mutations in these genes have been identified, some of which have been determined to be harmful and to increase risk of cancers.
L O V E M AT T E R S | 23
knowledge
L O V E M AT T E R S | 25A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 24
Community Paramedics
On the north Oregon coast, Adventist Health Tillamook is living God’s love through
the community paramedic program. Tillamook Ambulance, operated by Adventist Health,
serves Tillamook County — 25,000 people in 1,100 square miles and up to 150,000
people on summer and holiday weekends. The community paramedic program serves
patients who don’t qualify for home health services but still need someone to check
and care for them. This service is at no cost to the patient. It’s simply one way Adventist
Health extends its healing mission into the community.
nonmedical care. He checks to make sure they
are safe and have what they need to continue to
recover. Nick also does a home safety check for
fall hazards, making changes to reduce risk. He
assesses the need for durable medical equipment
and makes arrangements to get what his patients
need. He checks medications and even for food
safety, connecting patients with support agencies
that can help as needed.
“Being a community paramedic means listening
and caring,” says Nick. “A community paramedic
is afforded the ability to spend time getting to
know patients one on one in a personal way,
to get involved in their lives and help them be
engaged in their own wellness.
“One week I was sent to a gentleman who was
just discharged from the hospital, and he was
really worried about having a heart attack. When
I got to his home, I talked to him, performed
an EKG, and found he was having a STEMI (an
ST elevation MI). We were able to fly him from
In 2018, Nick Watts made 607 home visits,
caring for 164 patients. Case managers provide
referrals for patients at high risk for readmission
and who they feel could use extra support.
Nick may visit a patient in their home every
day for two weeks, providing both medical and
about a block away from his house directly to
definitive care, all very quickly. He would have
likely died if I hadn’t gone there and helped
him out.
“It’s been wonderful, and it’s also been sad.
My patients are usually towards the end of life,
so I help them navigate that, and you become
their friend, and when they pass away, it really
tears you up a little bit. But, what an honor to
accompany them on their journey.
“Our care no longer stops at the hospital door,
when we discharge a patient. Now they send me
out, free of charge, to help patients in any way I
can, to essentially keep them out of the hospital,
and make our community healthier and happier.
It’s a wonderful thing that we’re doing.”
By providing care to patients in their homes
when and where they need it, we are inspiring
health, wholeness and hope. Nick is helping
people as a free service to our community, and
we are living God’s love out loud. This is why we
are here, and it is what we are called to do.
caring
L O V E M AT T E R S | 27A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 26
At age 2, Aren wasn’t developing like other
toddlers his age. Seemingly unaware of
his surroundings, he was unable to walk,
form words, chew his food or even drink
through a straw. Aren was diagnosed with
autism, apraxia of speech and dyspraxia,
which limits speech ability and impairs fine
and gross motor coordination.
“Beneath Aren’s challenges and isolation from
not being able to speak, his sweet, determined
personality and analytical mind began to shine
through,” explains Traci Martinez, DPT, Play
to Learn Center manager. “With his iPad, Aren
interacts with the world. For his parents, hearing
the phrase ‘love you’ brought tears of joy.”
Now a third grader in public school, Aren is
studying all the usual subjects and is using an
iPad as his voice. He’s made friends and plays
just like other kids.
“Aren faces challenges in his life, but his progress
is a miracle in the making,” Traci adds. “I am
immensely proud of our staff, whose skills and
devotion to their work provide hope for the
better future of our children and their families.”
As for Aren, he wants to become, in his own
words, “a math teacher for kids like me who can’t
talk but can think, because they deserve it. I want
to teach them the value of numbers so that they
can go to the store and order what they want,
and no one can stop them.”
Facing extraordinary challenges raising Aren,
his parents were referred to Adventist Health Glendale’s Play to Learn Center — widely
recognized for its success with developmentally
disabled children. The Center’s team of skilled
physical and occupational therapists and
speech-language pathologists began working
with Aren and his family.
Speech pathologist Marie Elena Barth discovered
singing nursery rhymes was the magic that led to
the first meaningful communication with Aren.
Eager to find another medium for Aren to make
his wants and needs known, Marie began experi-
menting with an iPad.
Meanwhile, occupational therapist Steven Bates
worked relentlessly to improve Aren’s fine motor
skills, crucial for using the keyboard. Progress
was slow, but eventually Aren became proficient
at using the picture icons and keyboard to
connect with therapists and his parents, changing
the course of his future.
When Aren was 7 years old, his parents
discovered that by using his iPad, Aren could
compute arithmetic problems and understand
and read English, Armenian and French. He
could finally answer questions, make requests
and share his thoughts.
ABOVE: Adventist Health Glendale therapists, from left, Virginia Cheng, physical therapist; Steven Bates, occupational therapist; Norma Olvera and Natalie Pollak, speech-language pathologists; and Joanne Parrish, occupational therapist.
Aren uses an iPad to communicate his thoughts.
Inspiring each otherLiberty Rickman doesn’t know if she
would have found the strength to survive
without her nurse, Andreya Hooks. But
Andreya found inspiration in Liberty, her
patient who fought, even when she was
unconscious, to stay alive for her newborn
infant, her husband and three young
children at home.
Liberty and her husband, Luke Rickman, were
looking forward to the birth of their daughter.
Baby Laina was born early, at 27 weeks due
to preeclampsia, at Adventist Health Lodi Memorial. She was healthy and perfect.
Later that day, as doctors began anesthesia
for a routine tubal litigation, Liberty went into
malignant hypothermia, a rare allergic reaction
to anesthesia. They rushed her to the ICU, where
she was intubated to help her breathe. She was
on life support, frightened and struggling to
understand what had happened to her. Anxiety
and fear were taking over.
But then she met her ICU nurse, Andreya Hooks.
“Andreya took care of me and made sure I was
okay,” Liberty says. “It was the most terrifying
thing I’ve ever gone through, but Andreya made
me feel like we were in good hands.”
The next 13 days would be even harder, and
Andreya and Liberty would find strength and
inspiration in each other.
While Liberty was on life support in ICU, Baby
Laina was one floor below in maternity, where OB
nurses were holding and caring for her. All Liberty
wanted was to be with her baby, but the risk of
Laina contracting an infection from another ICU
patient was too great. Andreya devised a plan,
allowing Liberty to receive care in the OB unit,
even though she was no longer a patient there.
“In the OB department her husband and baby
could be by her side,” Andreya says. “Every one
had the same goal that night.”
Liberty was feeling more peaceful, but Luke was
concerned. “My husband thought something was
wrong, as I was struggling with my breathing,”
Liberty says.
The OB charge nurse was worried too, and called
a rapid response code. Andreya rushed in to find
Liberty crying, “Please don’t take my baby away
from me, please.”
“Tears were running down all of our faces
because Liberty had already been so traumatized,”
Andreya recalls. Once stabilized, an OB nurse
committed to staying in her room at all times.
However, complications arose, ending Liberty’s
time with Laina as she returned to ICU.
Liberty was stressed and Andreya was the only
one who could calm her.
“Every time I opened my eyes, she was there
telling me it was going to be okay,” Liberty says.
“If she wasn’t right beside me, she was talking to
my husband, calming him down.”
But for Andreya, it was Liberty’s determination
that was inspiring. “While she was intubated, she
was holding the baby and breastfeeding her. That
is a will to live. That is being a part of something
amazing.”
Just one day short of two weeks, Liberty was
able to return home. As she prepared to leave
the hospital, Andreya reminded Liberty of God’s
hand in her life. “You have a huge calling. I
promise, God has something in store for you,”
devotion
A MIRACLE IN THE MAKING
Play to learn
comfort
L O V E M AT T E R S | 29A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 28
In their work to stem the opioid epidemic
in Lake County, California, the team at
Adventist Health Clear Lake quickly
learned that reducing the volume of new
prescriptions and eliminating high-dose
prescriptions do not miraculously fix the
problem of addiction to these powerful
medications. Instead, responding to
the addiction crisis is a one-on-one,
relationship-oriented struggle faced by
both opioid users and healthcare
providers that requires intensive work
and a daily commitment.
Adventist Health Clear Lake is fighting this battle
through the partnership of our Intensive Case
Management Team, Live Well Program (which
offers addiction and pain management treatment)
and community organizations including
Project Restoration, a case management and
transitional housing program for medically fragile
members of the community who are homeless.
By identifying patients in the emergency room
who present with opioid dependence and
are homeless or approaching homelessness,
Adventist Health Clear Lake can offer options
for treatment and a chance at an addiction-
free future.
Marylin Wakefield, PhD, LCSW, Care
Management manager, shares a story of a
typical client of the program whom she met
recently. Ryan, in his late 20s, lived in the garage
of an abandoned home without running water
or electricity and he had no personal support
Opioids and beyond: Working at the community level
system. Ryan was in an accident that resulted in
prescribed opioids for pain management, leading
to a dependence on the drug. As he began to
heal, he tapered off the prescription but became
frightened without the opioid, so he turned to
street heroin. He was seen in the emergency
department for symptoms of withdrawal several
times. On one of those visits he was referred to
Marylin for intensive case management and to
Restoration House, a transitional home funded by
a grant from Adventist Health.
The work between Marylin and Ryan began with
a reverse planning priority-setting session, also
known as “backwards planning.” The goal is for
the client to share their vision for their future, and
to accept Marylin’s help to achieve that vision.
The resulting journey is a partnership of trust and
hard work. In Ryan’s case, he saw himself clean
of the addiction and with a permanent place
to live.
Restoring Hope
Shannon Kimbell-Auth is a member of the
Community Integration team at Adventist
Health Clear Lake, and the coordinator of Project
Restoration, a support program for medically
fragile homeless members of the community.
Shannon is passionate about Lake County’s
homeless population and works to offer a
whole-person approach to case management for
her clients that is centered around four tenets:
Life Saving — Life Changing — Life Sustaining
— Life Giving.
After Adventist Health Clear Lake raised funds
to purchase a shower trailer, Shannon galvanized
the Lake County Continuum of Care’s Interfaith
Council to manage its use and make it available
in communities around the county. When the
original warming shelter closed, Shannon secured
a new location. With Adventist Health Clear
Lake’s leadership and Shannon’s time and energy,
an additional $100,000 grant was secured
for sustained operations for Hope House, the
new site. Thirty-seven volunteers were trained
to serve at the center, including four paid intern
positions for Project Restoration clients, funded
by Adventist Health Clear Lake.
Shannon says, “It’s not just about being present
to the challenge of the moment, but catching
the vision of a world where people are helped
and housed and reaching for it like it’s already
in your grasp. That is one of the things we can
offer to our clients, hope for a future they can
reach. It’s attainable.”
The Adventist Health Clear Lake Intensive Care
Management Team started making calls and
requests for placements into treatment centers,
both residential and outpatient. Roadblocks
emerged: MediCal won’t cover residential
treatment, Behavioral Health doesn’t have the
resources to cover inpatient treatment, and
space is always hard to find. Marylin worked
with community partners and found a local
treatment center to get Ryan on suboxone, a
prescription medication that allowed him to be
gradually weaned off the pre-existing opioid/
heroin addiction while minimizing the withdrawal
symptoms. They began a program of therapy
to address the addiction and give Ryan tools
to use in the days to come. Together with the
Adventist Health Clear Lake physician team, they
also created an alternative pain management
approach and began focusing on Ryan’s general
health by connecting him with a primary care
physician. Everyone acknowledges that the
healing process will be ongoing.
Today Ryan has been clean for more than four
months. He lives in a stable housing situation
with friends. He has received a job offer for
a position he will start when he reaches six
months clean.
transformation
L O V E M AT T E R S | 31A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 30
Surrounded by mountain ranges and nestled in the citrus-growing region of
Mexico lies Montemorelos, home to one of the preeminent Seventh-day
Adventist universities. The University of Montemorelos promotes research,
selfless service and a missionary vision with the Adventist hope of a new world.
1,000 miles and 1,000 hours: MISSION TRIP TO MONTEMORELOS
Two groups faced with similar challenges
created a perfect opportunity for sharing and
collaboration. In November 2018 the team
set out from Los Angeles to partner with the
university in their mission to serve the
Montemorelos community.
“I’ve always felt a calling to do missionary work,”
says Patricia Stone, RN, MSN, patient care
executive, Adventist Health White Memorial.
Montemorelos University’s focus on nursing
education in addition to community service was
a perfect fit for Pat. Her goal is to help foster the
ongoing relationship with the university through
education and work exchange opportunities.
The joint team of students and volunteers
reached out to Montemorelos elementary
school children to educate them on good health
practices. The entire community was invited
to a health fair featuring healthy diabetic diet
cooking demos and exercise classes. Many who
lined up for health screenings and diabetic foot
care appreciated the opportunity to talk with a
healthcare professional. “People need someone
to listen to them when they’re feeling vulnerable,”
says Nestor Mondragon, a university medical
graduate and a member of the mission trip team.
One of the most dynamic events of this trip was
the Shark Tank-like event held at the university.
The students pitched their community service
projects to a very receptive audience. More
than $10,000 in funding was granted. One of the
winning projects is to build greenhouses to grow
fruit and vegetables, serving as a community
educational lab for student-led teaching. Another
project will construct stair steps for the hillside
homes, allowing residents access even in
heavy rain.
The benefits of this mission trip will be felt
by the people of Montemorelos for years to
come, and the bond between Adventist Health
White Memorial and the university was further
strengthened. “Mission work is an investment in
your spiritual life,” Nestor says, “You are more
blessed than those you serve. The feeling you get
from their smile and a thank you — that can’t be
gotten anywhere else.”
However, beyond the campus lies much poverty.
Many families live in primitive dwellings with no
indoor plumbing. Hillside homes can be impos-
sible to reach after heavy rains turn dirt trails to
mud. Although Montemorelos is an agricultural
area, the communities have little access to fruits
and vegetables for a healthful diet. Diabetes is
widespread for those living on starchy foods.
The university students are on a mission to help
their less fortunate neighbors. Each student
performs more than 1,000 hours of community
service, aligning with the university’s health
sciences programs.
More than 1,000 miles away, the medical campus
of Adventist Health White Memorial resides
in a densely populated neighborhood alongside
downtown Los Angeles. The residents of this
neighborhood have a high rate of diabetes, and
many suffer from its complications. Adventist
Health White Memorial has become highly skilled
in diabetes management and treatment, offering
programs featuring diet, exercise and a multi-
disciplinary approach to treating patients at risk
of foot and leg amputation. service
L O V E M AT T E R S | 33A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 32
Rico Fernandez found more than just a job
at Adventist Health Selma. He found a
work environment that encouraged him
to freely express his love for God and his
passion for music. Rico provides desktop support to the clinical
staff at the hospital. One day he overheard staff
discussing concerns about a patient who seemed
to be growing more agitated and confused as
the days passed. They were worried and were
looking for a way to comfort her.
Rico asked Jennifer Gomez, RN, “Do you think
music would help?”
Rico is a musician who plays the saxophone and
the Irish flute — he calls it a “tin” flute — among
other instruments, in his church. His instruments
were in his car and he wondered if their patient
would enjoy hearing him play. Jennifer agreed it
would be worth a try.
The patient and her husband didn’t speak
English, so their son translated the request for his
father, who agreed to let Rico play for her. He ran
to his car to get his instruments.
Rico began by playing “Amazing Grace” for
the woman. She gradually became calmer. He
moved on to “Bless the Lord,” and after a few
more songs she was resting easily.
“He was so happy to do it,” Yolanda Andrews,
RN, says. “He even prayed with her.”
As the notes drifted down the hall, other patients
began searching for the source of the music,
asking if Rico could play for them. “He played for
at least three more patients,” Jennifer recalls.
Rico has been playing music for more than 30
years. When he was a youth living in Southern
California, he and his brother would take their
instruments to skid row in downtown Los
Angeles and play for the homeless. He says
he has found music can almost always break
through the toughest exteriors.
On that day, however, he says he just wanted to
try to help the patient relax.
“I could hear her making sounds like she was in
pain. I felt concern for the family and wanted
to help,” Rico says. “I like that we’re encouraged
to pray at work, and I’m glad that her husband
said I could pray with her,”
In the days that followed, Jennifer says, patients
would come to the nurses’ station and ask the
staff, “What time does the music happen?”
When does the music happen?
A couple who volunteers together stays
together, as Jan and Larry Moberg will
tell you. They recently celebrated 55 years
of marriage, and they credit their weekly
volunteer work at Adventist Health Sonora with keeping their relationship
strong.
“We have a fun time talking about our day,”
says Jan Moberg. She and her husband spend a
combined 10 hours weekly working separately at
the hospital, but come together at the end of the
day at their Copperopolis, California, home.
And of course, there are the dogs, a mutual love
that Jan and Larry share.
“The dogs help us stay together,” says Larry
Moberg, with his companion, Tank, by his side.
Tank became Larry’s companion when he was
battling melanoma.
Jan found Tank at the Humane Society of
Tuolumne County in Jamestown. “Tank walked
right up and leaned against Larry,” she says with
tears in her eyes. The dog stayed with Larry
throughout his treatments, even accompanying
him to doctor’s appointments.
“The things that help you heal are family,
medication and dogs,” says Jan, a retired
psychotherapist. She cites studies that show
interaction with dogs has real impact on people’s
health — lowering blood pressure, heart rate and
stress levels.
The Mobergs have witnessed the power of
canines firsthand, and now they spend time each
week sharing it with others.
As the couple walks the third floor of the hospital
with Tank and Jan’s dog, Sami, the staff greet
the dogs by name, sometimes stopping to offer a
good scratch.
Larry and Tank enter one of the hospital rooms,
and the dog enthusiastically leaps onto the bed of
Jamie Severson.
“That’s love,” says Jamie, recovering from two
major surgeries. She begins to cry as Tank lays
his head in her lap. “That’s when you know you
can get better. And I didn’t know if I was going
to, but now I know.”
Jamie recalls one day that was especially hard,
but being with a dog raised her spirits and carried
her through. “This place saved my life, and those
dogs were part of it,” she says.
“I love to chat with the people,” Jan says. “We
don’t talk about their ailment, but we talk about
dogs or something else. It’s somebody different
for them to look at and talk to other than the
same personnel and doctors they see every day.”
Larry Moberg with his dog, Tank, and Jan Moberg with her dog, Sami, taking a break from visiting patients and staff for a photo at Adventist Health Sonora.
grace
sharing
Comfort and compassion with animal companions
L O V E M AT T E R S | 35
E V E R Y
I S VA L U E D
A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 34
L O V E M AT T E R S | 37A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 36
On a routine Friday morning, Mikayel Grigoryan, MD, an interventional
neurologist at Adventist Health Glendale, could not imagine how quickly his
day would change.
“The patient was not a candidate for tPA, the
clot-busting medicine given through an IV,” Dr.
Grigoryan explains, “and the imaging studies
suggested that it was too late to do an
intervention — attempting to unclog the vessel.
Few hospitals in the Los Angeles area have that
capability.”
That’s when Dr. Grigoryan received the call. “The
emergency room doctor and neurologist felt that
Brandon deserved an aggressive treatment — he
was only 33 years old,” Dr. Grigoryan says. “But
his only chance was being rushed to another
hospital that could do the procedure.”
Adventist Health Glendale is known as one of
Southern California’s leading Comprehensive
Stroke Centers, skilled in advanced lifesaving
procedures performed by Dr. Grigoryan and
neurosurgeon Yaser Badr, MD.
Thrombectomy is the medical term for removing
clots from the brain, which unclogs the vessels.
A tiny catheter with a wire inside is delicately
guided through blood vessels from the leg to the
brain, where it penetrates the clot and removes it
by retrieval or suction.
“I received the images and felt Brandon had a
chance,” Dr. Grigoryan explains. “We don’t apply
the same universal protocol to patients when it
comes to strokes. It takes thinking outside the
box, and we had a different opinion from the
first hospital. I told the family that, without this
intervention, Brandon would probably die or
become profoundly disabled.”
Penny Stott, Brandon’s mother, remembers those
words. “Dr. Grigoryan was honest; he said he’d
try. There was no guarantee, but he was actually
going to do something.”
Brandon was transported to Adventist Health
Glendale, and by late afternoon a stroke team led
by Dr. Grigoryan successfully extracted a blood
clot nearly 4¾ inches long.
During the next four days in the ICU, Brandon
slipped in and out of awareness. What happened
next, however, amazed those around him. Speech
therapists often help stroke patients learn to
speak again by singing songs — simple nursery
rhymes. And so it was that, as if a lightbulb
clicked on in his brain, Brandon remembered that
his daughter, Jayden, was turning 5 years old.
With tears streaming down his face, he quietly
sang “Happy Birthday.”
“I cried,” Penny says. “Everyone cried. It was a
miracle.”
Within a few days, Brandon was up and walking.
And on discharge day from the medical center’s
physical medicine and rehabilitation unit, he and
Dr. Grigoryan were walking briskly down the
hallways.
Brandon continues to improve, his wife, Nora,
reports. “Aside from saving Brandon’s life,
Dr. Grigoryan has become part of our family.
We appreciate him so much. We wouldn’t go
anywhere else.”
A young life saved
Brandon Stott with his wife, Nora, and two of their children, Jayden and Brandon Jr., with Mikayel Grigoryan, MD.
A fellow neurologist from a San Gabriel Valley
hospital was on the phone; a story of a life in
danger was unfolding. His patient, Brandon Stott,
lay nearly motionless and unable to speak in his
hospital’s emergency department. Images of his
brain revealed this robust young man was
experiencing a life-threatening stroke. A large
clot in a major vessel was blocking blood flow to
the left side of Brandon’s brain.
Josh Medeiros, facilities manager at
Adventist Health in California’s Central
Valley, realized that, even though he’s not
a caregiver in title, he can still have an
impact on a patient’s hospital experience.
Josh and his co-workers needed to manually
change all of the clocks at Adventist Health Hanford one hour ahead, due to daylight saving
time. They challenged each other to see who
could finish the task first. Josh decided to have a
little extra fun, and as he entered each room he
introduced himself with a new job title.
“I would say, ‘Hi, I’m Josh, and I’m with the Time
Travel Division. I’m here to update your clock.’ ”
He remembers entering one patient’s room.
As he delivered his time travel line, the woman
laughed and engaged him in a conversation. He
stayed and talked to her for a while, and noticed
sanitizing wipes and plastic hand gloves, instead
of flowers and cards from family, on shelves he
had previously installed.
“I realized she didn’t want to talk to me, she just
wanted to talk to somebody,” says Josh.
Josh knew what to do. He visited the hospital
gift shop and purchased a card and flowers. He
went back to the patient’s room and told her he
noticed her shelf was being misused. He removed
the gloves and sanitizing wipes, placed the
flowers on the shelf and gave her the card.
“She started to break down,” says Josh. “She said
nothing like this ever happens to her. She reacted
as if she had won the lottery or won some kind
of prize.”
Josh sat with the woman for about 10 minutes,
understanding he had changed her whole hospital
experience.
“I might come unclog your sink and replace your
lightbulbs or a ceiling tile and go home at the
end of the day and think, ‘I’m just a maintenance
guy,’ but it’s nice to know we have an impact on
patient care too.”
T I M E T O C A R E
innovation
experience
L O V E M AT T E R S | 39A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 38
High school students in Portland, Oregon,
are introduced to healthcare careers
through the innovative Student Healthcare
Leaders program developed by Terry
Johnsson, Adventist Health’s Pacific
Northwest Region executive director of
mission integration, and funded by the
Adventist Health Portland Foundation.
This program is designed to inspire hope for
youth who are contemplating career pathways.
More than 50 students have participated in three
10-week sessions so far. All student applicants
are accepted into the after-school program and
provided with scholarships. They meet weekly
to visit and learn about a specific department
at Adventist Health Portland. The students
have explored information technology, security,
food services and clinical areas.
“I recently read that 78 percent of healthcare
workers had someone in their family who worked
in healthcare,” Johnsson explains. “Unless these
young people get this exposure, they’ll never
know they can be in healthcare. I wanted to
start a program that would introduce youth, not
just to the medical part of the hospital, but to let
them know that the hospital is like a city, and
if you like IT work, you can do that right here.
We developed a 10-week program where young
people will get a chance to hear fantastic stories
from associates, have the opportunity to do some
hands-on work, and help inform their future
career choices. They’re going to get the whole
view of what takes place in a hospital.”
“The program has made me consider fields that
I didn’t previously know existed in the healthcare
world.”
— Ben Kruger-Blehm, student
“I really like healthcare and being there with the
patients. I’ve also had a calling to ministry, so I
was wondering where I can do both ministry and
healthcare? And I realized that chaplain would
be a great option. And actually, Uncle Terry is a
chaplain, so he said, ‘You need to do this. You need
to see the healthcare part of it.’”
— Alyssa Fresse, student
“We got to play a game of Operation on an
operating table with the Da Vinci robot. It’s a
tool that they use in surgery, and we got to have
Dr. Rippey show us how to use it.”
— Jolie Brown, student
“Besides exploring the healthcare field, something
we did over the course of the program was finding
our “strengths” or predominant leadership talents.
By finding my strengths, I was able to think on
the brighter side of things and think about things
I was doing right and things I was good at rather
than things I needed to fix. With the combination
of exploring the healthcare field and finding my
strengths, I am certain I am prepared to pursue a
career in healthcare but most of all, to pursue it as
a leader.”
— Ari Strauss, student
Student healthcare leaders
Meet Dalia Branch, the daughter of Diana
Branch, who works in Adventist Health White Memorial’s pediatric rehabilitation
and cleft palate program. For her seventh
birthday, Dalia wished for a lemonade
stand. To her delight, her wish came true.
It was perfect — a green and yellow
awning with dressed poles connecting to
a beautiful “Fresh Lemonade” marquee.
Dalia’s lemonade, served with love
Dalia’s lemonade service debuted at a car
show on Father’s Day weekend and earned
$150. What’s a 7-year-old girl to do with all that
money? Toys? Games? She sought the advice of
her mother, Diana, who replied, “You can buy
anything you want; you can even donate some.”
Dalia had watched her mom work with a group
of dedicated caregivers to help cleft palate
patients — children born with severe deformity
of the mouth and/or nose. She had heard stories
of children who suffered cruel bullying simply for
looking different and learned of the bravery of
these patients to endure multiple surgeries. She
also knew that many who needed help couldn’t
afford it. So rather than spending the money on
herself, she decided to donate all of it to the cleft
palate program.
And she didn’t stop there. Dahlia has dedicated
her lemonade stand to raise even more money
for the program. She set up her stand at every
car racing event her parents went to. She even
hosted her stand at the Adventist Health White
Memorial Foundation Gala and the City Gala in
Los Angeles.
In 2018, Dalia raised more than $3,700. In
addition, friends and family from all over the
country have donated more than $5,000. So far,
Dalia has donated over $9,000 to the cleft palate
program!
Dalia is inspiring hope everywhere she goes, and
knows that her lemonade, and her love, make a
difference.
learning
giving
L O V E M AT T E R S | 41A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 40
Don Damp recalls when roles were reversed,
“I know how it feels to be homeless. I spent 12
years isolated and homeless in the woods of
Mendocino County. I needed help and medical
attention and was reluctant to get it. That was
until Buddy Eller helped me. Buddy started by
building trust and forming a relationship with me
— human to human. He kept me focused every
day until soon I realized there was another, better
way to live. It took a year and a half for me to
quit drinking, secure housing and obtain financial
stability. A large part of my journey to wellness
included volunteering full-time, helping those I
felt needed the most support.”
Don’s personal experience with homelessness
and addiction positions him well for his role
with the Adventist Health Ukiah Valley Street
Medicine team. “It’s so important to have
someone who has ‘lived it’ to connect with the
people we are trying to help,” shares Joel Soinila,
a colleague of Don’s who also works with the
team. “Don sees himself in the lives of the local
homeless men and women we serve, and it is the
relationship he builds with them that allows us all
to make a bigger impact.”
Don is now the homeless representative for the
Mendocino County Continuum of Care Coalition
and takes pride in being the voice for those who
historically have not had a seat at the table. He
continues to volunteer, serving meals to the
homeless, collecting data for the Point-in-Time
Count and wherever else a helping and loving
hand is needed.
A journey of love leads to a lifetime of givingCarrying backpacks loaded with medical gear and supplies, Don Damp, of Adventist Health Ukiah Valley’s Street Medicine
Program team, takes healthcare to the streets to help the underserved. His mission isn’t just about providing medical care;
it’s about building trust and sharing love and compassion over time that makes the difference in the lives of those he serves.
It is clear to everyone that Don’s love of helping
others has no boundaries. Because of this, we’ve
been able to serve hundreds of patients who
otherwise may not have access to the treatment
they need.
When Lawrence Nagasawa Jr. had his left
knee replaced at Adventist Health Castle in 2018, then his right knee in
2019, he received more than just pain
relief and restored joint function. Weighing
in at 380 pounds prior to the surgeries on
his knees, Lawrence has lost 90 pounds
following the low-carb diet his physician,
Linda Rasmussen, MD, puts all her joint
patients on prior to surgery.
Lawrence says, “I lost weight, my blood work
came back much better, and not only is my
primary care physician happy, my wife believes
in the program and won’t let me stray off the
diet!”
“I got to know the nurses on Ho’okipa pretty
well,” he says, “since I had both knees replaced
and had the same nurses each time. I am so
grateful to them for putting up with me and
my sense of humor. I love them, they were so
attentive, very gentle and courteous, and so
pleasant.”
Lawrence is a farmer, and before his surgeries
he was having trouble with his daily routine that
involved getting onto the tractor or mower, or
climbing up a ladder, “Now I’m happy and doing
great,” he says.
“In fact,” says Jane Raymond, project specialist
for Castle’s Joint Care Services, “he even spoke
at one our seminars and was awesome.”
Whole health for life
“I have a new lease on life, not just because of the surgery, but because the diet has made me healthier on so
many levels,” Lawrence says. “I guess I’ve been sentenced to life on this diet and I couldn’t be happier!”
trust
gratitude
L O V E M AT T E R S | 43A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 42
miracles
Soothing a child’s pain“No available appointments,” is the last
thing a mother wants to hear when she’s
trying to find someone to help her
suffering child. Amy Gallegos’ daughter,
Emma, had a painful rash, but her primary
care doctor wasn’t available to see her,
and an urgent care appointment was
hours away.
When Amy first saw Emma’s rash, it had already
covered much of her body. “I tried not to panic
and focused on getting her the most appropriate
care as soon as possible,” she says.
Amy’s colleague, Mary Ann Carousso, works
at Kings Canyon Unified School District in
Reedley, California, and recommended she try
the Adventist Health school-based clinic that
partners with the school district. Adventist Health Medical Office – Reedley Jefferson
is a full-service medical office that was built on
the Jefferson Elementary campus in 2013 and
cares for hundreds of patients each month.
The school-based medical site provides primary
and specialty care and same-day visits for
children and families from the school district and
surrounding area. Adventist Health also provides
health and nutrition education for students,
parents and district staff.
The team at Reedley Jefferson quickly made
an appointment for Emma and told Amy how
she could relieve her child’s pain before the
appointment.
Their kindness continued at the medical office.
“They gave her medication to treat her flare-up
and cared for her until symptoms started to
subside,” says Amy. “They were very reassuring,
and we didn’t leave until she showed signs of
improvement.”
What could have turned into hours of
unnecessary pain for a young child, turned into
a pleasant experience easily accessible to Amy
and Emma. “The whole mission statement
behind Adventist Health has really served
people,” Amy says. “I’ve seen it with other
people but having lived it was a whole different
experience.”
With her condition under control, Emma was
able to return to the things she loves most:
playing soccer and football and pursuing her
dreams of becoming a zookeeper!
Amy Gallegos, left, was thrilled with the care her daughter, Emma Claire Avila, received at the Reedley Jefferson medical office, including the care of medical assistant Nelly Trevizo.
The first responders who helped
Sebastian Fernandez after he nearly
drowned gathered at Adventist Health Simi Valley for a joyful reunion with the
boy, three years after the eventful day.
“He had no heartbeat for 46 minutes,”
recalled Mireya Rodriguez, Sebastian’s
mother. “So, he’s our little miracle.”
In 2015, young Sebastian tumbled into the
family pool and remained, face-down, in the
water until his cousin and sister found him. The
family began CPR and called 911, but when the
ambulance arrived, he was not breathing and had
no heartbeat. The team rushed him to Adventist
Health Simi Valley, where the emergency
department worked tirelessly to restore his
heartbeat and get him breathing again.
Sebastian’s aunt, Liliana Rodriguez, says the
nurses’ determination made all the difference.
“The nurses didn’t stop working on him,” she
recalls. “They knew he was gone, but they could
not let themselves stop, and that made all the
difference in the world. God’s got a plan for this
little boy.”
Once stabilized, Sebastian was transferred by
air to a pediatric facility for specialized care.
However, the team who answered his family’s
urgent call for help wondered if their tiny patient
survived his ordeal. There was little time to
process the event or to grieve, as each of the first
responders went on with their day — and week,
and year — coming to the aid of others in need.
Their question was finally answered. Chantel
Allen, the emergency department charge nurse,
met Sebastian’s mother through a school event.
Discovering their connection, Mireya asked how
she could thank those who were responsible for
saving her son’s life.
On December 7, 2018 — one day short of three
years since Sebastian’s tragic accident — he and
his mother returned to the hospital to thank the
men and women who had saved his life. Now
4 years old, Sebastian arrived in his “snug seat,”
a special transport chair. His sparkling brown
eyes and wide smile lit up the room and touched
the hearts of the caregivers who had carried the
image of a toddler barely clinging to life.
The day was particularly emotional because
the first responders only learned of Sebastian’s
survival when they received an invitation to
the event. Rachel Stanley, an officer with the
Simi Valley Police Department, remembered
responding to Sebastian’s accident. “You want
closure, but you don’t want to reach out to the
family if it was bad — so we didn’t know if he
had survived. I’m so happy to see him thriving.”
“This is living proof of why we do what we do,”
says Kristen Shorts, one of the nurses who helped
to save Sebastian’s life.
A joyful reunion
Four-year-old Sebastian, pictured here with his mother Mireya during their visit back to Adventist Health Simi Valley, brings nothing but smiles to the faces of those who cared for him after his accident three years ago.
access
L O V E M AT T E R S | 45A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 44
Meeting patients where they are
Adventist Health and Rideout in Marysville, California, are integrating healthcare into the community through a street nursing program serving the homeless population.
engaged and looking for work. Ashten Phillips,
our patient care coordinator, found them housing
after the baby was born. She is currently staying
with the Regional Emergency Shelter Team, a
church-based organization focused on helping
homeless families.
“We have a registered nurse from our emergency
department and our patient care coordinator
out every Tuesday and Thursday. The nurse’s
primary function is to take vital signs, identify key
medical issues, educate the patient and connect
them to care. The patient care coordinator
connects people to benefits, resources, housing,
food and transportation. We’ve also picked up
the costs of some medication because they were
non-compliant and needed the care.”
The team saw 165 patients in coordinated
locations in January 2019, including 65 who
came in as the result of a one-day Point-In-Time
Count conducted with Yuba and Sutter counties.
Teri adds, “Our vision is to take it out to the
river bottoms to bring healthcare with a nurse
practitioner, social worker, etc., as well as a
virtual visit with a doctor, to assess whatever is
going on, to take a look at the patient in the field
and help us make a decision about what to do.”
“Nurses head to the river bottoms or
homeless entry locations twice a week
with backpacks containing basic medical
supplies. We hope to one day soon bring
virtual care in order to start triage from
our emergency department team, and
bring patients into the ER when
appropriate,” says Teri Howard, Adventist Health and Rideout’s director of Case
Management, who helps lead the
program.
The team is combining healthcare with social
work, assisting the various government and
volunteer organizations in helping the homeless
integrate back into the community.
“We met a 25-year-old diabetic, pregnant
female not taking insulin or keeping doctor’s
appointments,” Teri says. “She didn’t know her
due date. We looked at her, triaged her, and
evaluated her at the ER. After five days in the
hospital, we released her with insulin. We saw
her later at a local homeless shelter and
coordinated entry point, and her blood sugars
were better and her significant other was
connection
L O V E M AT T E R S | 47A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 46
Adventist Health Portland30 Medical OfficesHome Care ServicesRetirement Center
Portland
Adventist Health Tillamook9 Medical OfficesHome Care Services
Adventist Health Castle 6 Medical Offices Home Care Services
Honolulu
Kailua
Retirement CenterWalla Walla
PACIFIC NORTHWEST REGION
Com
mun
itie
s w
e se
rve
Clearlake
Roseville
Paradise
Marysville
Adventist Health Ukiah Valley14 Medical Offices
Adventist Health RosevilleSystem Headquarters
Adventist Health Feather River7 Medical OfficesHome Care Services
Adventist Health and Rideout15 Medical OfficesRetirement Center
Adventist Health St. Helena16 Medical Offices
Home Care Services
Adventist Health Vallejo
Adventist Health Sonora26 Medical OfficesHome Care Services
Sonora
Willits
Ukiah
Adventist Health Howard Memorial
1 Medical Office Home Care Services
Adventist Health Lodi Memorial21 Medical Offices
Home Care Services
Adventist Health Clear Lake9 Medical Offices
Home Care Services
St. Helena
Adventist Health Simi Valley5 Medical Offices
Home Care Services Adventist Health Glendale12 Medical OfficesHome Care ServicesLos Angeles
3
Adventist Health White Memorial8 Medical Offices
Home Care Services
Central Valley NetworkAdventist Health Reedley 1
Adventist Health Selma 2Adventist Health Hanford 3
Adventist Health Tulare 462 Medical Offices
Home Care Services
12
Adventist Health Bakersfield10 Medical Offices
Home Care Services
Bakersfield
Fresno
Adventist Health Tehachapi Valley3 Medical OfficesHome Care Services
San DiegoRetirement Center
Rural Health Clinics
CENTRAL CALIFORNIA REGION
SOUTHERN CALIFORNIA REGION
NORTHERN CALIFORNIA REGION
4
Adventist Health is a faith-based, nonprofit
integrated health system serving more than
80 communities on the West Coast and Hawaii.
Founded on Seventh-day Adventist heritage and
values, Adventist Health provides care in hospitals,
clinics, home care agencies, hospice agencies and
joint-venture retirement centers in both rural and
urban communities. Our compassionate and talented
team of 35,000 includes associates, medical staff
physicians, allied health professionals and volunteers
driven in pursuit of one mission: living God’s love
by inspiring health, wholeness and hope. Together,
we are transforming the American healthcare
experience with an innovative, yet timeless,
whole-person focus on physical, mental, spiritual
and social healing.
L O V E M AT T E R S | 49A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 48
Adventist Health’s mission statement of “living God’s love by inspiring health, wholeness and hope”
is coupled with a vision to transform the health experience of our communities by improving health,
enhancing interactions and making care more accessible. We are inspired by healing ministry as
represented by the life of Jesus Christ and believe we are called to live out our mission intentionally
in the communities we serve. In the small towns, suburbs and inner cities we serve, we continue our
journey to provide quality healthcare until every person made in God’s image has experienced the
best health today, hope for tomorrow and God’s love that endures forever.
2018 Adventist Health community benefit totals
$45,189,009Free and discounted care
$98,568,219Aid to the poor
$23,731,866Community health
improvement
$29,080,520Education and research
$259,863,670Aid to the elderly
$88,528,206Subsidized community
healthcare$544,961,490
TOTAL
14% 9%
$54,825 $68,719
21% 15%
76% 84%
Households receiving food stamps
Source: USDA
Average family incomeSource: US Census Bureau
Below poverty levelSource: US Census Bureau
High school graduate or higher
Source: Bureau of Labor
Payer mixSource: OSHPD 2017
At Adventist Health we are privileged to serve a broad spectrum of our community. We also recognize there are those in
the community who are suffering.
We are committed to providing
excellent healthcare through
partnerships with our communities
to help them become healthier,
better places to live.
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
2017
2013
2014 2015
2016
2013
42%
28%31% 29%
25%
41%
2% 2%
Medicaid Medicare Private Coverage Other
•Adventist Health Communities •California
M A T T E R S
Community Integration
L O V E M AT T E R S | 51A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 50
2018 Selected Facts and Statistics
Financial Summary For year ended December 31, 2018
Clinic Visits
in thousands
2018
2017
2016
2015
2014
2,032
1,747
2,060
2,247
2,124
0 500 1,000 1,500 2,000 2,500
Clinic Visits in thousands
2,500
2,000
1,500
1,000
500
0
20
17
20
13
20
14 2
01
5
20
16
Admissions
0 20 40 60 80 100 120 140 160 in thousands
2018
2017
2016
2015
2014
152
Admissions in thousands
160
140
120
100
80
60
40
20
0
20
13
20
14
20
15
20
16
20
17
5.0
4.5
4.0
3.5
3.0
2.5
2.0
1.5
1.0
5
0
0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0
149
153
145
139
Emergency Department Visits
in thousands
2018
2017
2016
2015
2014
Emergency Department Visits in thousands
800
700
600
500
400
300
200
100
0
20
17
20
13
20
14
20
15
20
16
0 100 200 300 400 500 600 700 800
724
697
686
649
587
WORKFORCEEmergency Department Visits
723,987
Associates 25,000
Physicians 5,000
Volunteers 1,800
As a nonprofit organization, all net revenue over expenses is channeled back into our hospitals and health
system. Unlike for-profit healthcare organizations (where money becomes dividend checks to investors), this
money funds capital improvement, enhanced patient care, new hospital programs and community outreach.
Admissions
152,499 Outpatient Visits
1,518,813Home Health Visits
217,326Clinic Visits
2,032,342
Net revenue received from patient care and other sources of income . . . . . . . . . . . . . . $4,434,000,000
Expenses incurred in rendering patient care and other services . . . . . . . . . . . . . . . . . . .$4,317,000,000
Margin available for equipment, plant and property improvement, working capital needs, and repayment of long-term debt . . . . . . . . . . . . . . . . . . . . . . . $117,000,000
Total Operating Revenue
$ in billions
2018
2017
2016
2015
2014 $3.3
$3.6
$4.1
$4.4
$3.9
0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5
Total Operating Revenue $ in billions4.5
4.0
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
20
17
20
13
20
14
20
15
20
16
EBIDA Dollars
0 20 40 60 80 100 120 140 160
$ in millions
$280.5
$345.3
$395.9
$414.1
$354.0
EBIDA Dollars$ in millons
450
400
350
300
250
200
150
100
50
0
2013
2012
2014
2015
20
17
20
13
20
14 2
01
5 20
16
0 50 100 150 200 250 300 350 400 450
2018
2017
2016
2015
2014
EBIDA Margin
in thousands
2018
2017
2016
2015
2014 8.7%
10.0%
10.1%
8.0%
9.6%
Clinic Visits in thousands
2,500
2,000
1,500
1,000
500
0
20
17
20
13
20
14 2
01
5
20
16
0% 2% 4% 6% 8% 10% 12%
Operating Margin
0 20 40 60 80 100 120 140 160
in thousands
2018
2017
2016
2015
2014
2.6%
5.0%
3.5%
4.6%
3.0%
Operating Margin5.0
4.5
4.0
3.5
3.0
2.5
2.0
1.5
1.0
5
0
20
17
2013
20
14 20
15
20
16
20
13
0 0.5% 1.0% 1.5% 2.0% 2.5% 3.0% 3.5% 4.0% 4.5% 5.0%
L O V E M AT T E R S | 53A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 52
Board of Directors
(LEFT TO RIGHT) John Freedman, Andrew Davis, Scott Reiner, Velino Salazar, Rich Reiner, Marc Woodson, Bill Wing, Ricardo Graham,
David Banks and Larry Innocent
Not pictured: Robert Cherry, MD, and Kerry Heinrich
Executive Cabinet
(LEFT TO RIGHT) Bill Wing, President; Jeff Eller, President, Northern California Region; JoAline Olson, Chief Human Performance Officer;
Wayne Ferch, President, Central California Region; Joe Reppert, Chief Financial Officer; John Beaman, Chief Business Officer;
Hoda Asmar, MD, Chief Clinical Officer; Mark Ashlock, President, Ambulatory and Post-Acute; Scott Reiner, Chief Executive Officer;
Joyce Newmyer, President, Pacific Northwest Region; Andrew Jahn, President, Southern California Region.
A D V E N T I S T H E A LT H M I S S I O N R E P O R T | 54
Adventist Health Castle
Adventist Health Clear Lake
Adventist Health Feather River
Adventist Health Lodi Memorial
Adventist Health Howard Memorial
Adventist Health Hanford
Adventist Health Glendale
Adventist Health Bakersfield
Adventist Health Simi Valley
Adventist Health Reedley
Adventist Health Sonora
Adventist Health Portland
Adventist Health St. Helena
Adventist Health Selma
Adventist Health Tehachapi Valley
Adventist Health Vallejo
Adventist Health Tillamook
Adventist Health White Memorial
Adventist Health Ukiah Valley
Adventist Health and Rideout
M A T T E R S
CREDITS | Executive Editors: Dustin Aho and Joshua Cowan | Managing Editor: Jenni Glass | Writer: Kim Tackett, Tackett + Barbaria | Editorial Staff: Sandra Meyers
Photography: Gordon Lazzarone and Adventist Health local markets | Design: Steve Barbaria, Tackett + Barbaria | Project Management: Kim Tackett, Tackett + Barbaria
Adventist Health | One Adventist Health Way | Roseville, CA 95661 | 916-406-0000 | AdventistHealth.org | © 2019 Adventist Health
Adventist Health Tulare
AdventistHealth.org